The ribs are a set of bones that stem from your spinal column, around your body and attach to your sternum / breastbone. These bones serve to protect the contents of your thoracic cavity. They also serve as an attachment point for many muscles and are active during respiration. Overall, you have a total of 24 ribs; 12 on each side of your body.
There are three parts of each rib – the head, the neck, and the shaft (or ‘body’, of the rib). The head of your ribs is shaped like a wedge and has two very specific areas called facets. These facets articulate with your spinal vertebrae.
Ribs are difficult to break – they are a bony framework that protects the vital organs located within the chest cavity. They are also surrounded by strong muscles and typically can take a lot of abuse before they crack.
Broken ribs are a crack or break in one of the bones of the rib cage. A break in the thick tissue (cartilage) that connects the ribs to the sternum may also be called a broken rib, even if the bone itself is not broken. Your ribs work to perform two main functions for your body – they protect the organs in your chest, and they also help you breathe by keeping space open inside your chest while the muscle you use to breathe squeeze in, or contract.
This should leave plenty of space for your lungs to fill up with enough air. The muscles used for breathing pull on the ribs, so breathing may be extremely painful when you have a broken rib. Therefore, it is important to seek immediate medical attention if you suspect a broken / fractured rib. A blow that is hard enough to break a rib could also injure your lungs, spleen, blood vessels, or other parts of your body.
Causes & Symptoms
Commonly, the rib is broken in one place and is considered an incomplete fracture. Completely broken ribs may or may not move out of place. If they do move, they are known as ‘displaced rib fractures’ and are likely to puncture your lungs or damage other tissues and organs. Ribs that tend to stay in place (typically ribs that aren’t completely broken in half) are called ‘non-displaced rib fractures’.
Rarely, a specific section of the rib cage breaks away from the surrounding bone and muscle. This area loses its stable structure and moves fairly easily as the patient breathes. This section is known as a flail segment and is much more dangerous than simply broken ribs.
Your ribs are designed to withstand a lot. However, sudden and severe blows to the chest and back can fracture them. Broken ribs can be the result of the following causes below:
- Car accidents
- Contact sports (such as football or basketball)
- Hard falls to the chest
- Personal violence, such as domestic abuse
- Repetitive trauma from sports such as golf or rowing
One of the most common symptoms of a broken rib is chest pain when you take a deep breath. Inhaling deeply may impact your ribs even more. Laughing, coughing, or sneezing can also send sharp pains shooting from the site of the break. You may also notice swelling and redness around the break. In some cases, you might also see bruising on the skin near the broken ribs.
Depending on the location of the fractures, bending over, or twisting your upper body may also trigger sudden pain. Striking or pressing on the fracture will cause pain for at least several weeks. Another symptom linked to broken ribs is restlessness. You may find it difficult to find a better position to sleep due to the fractured rib causing pain in your chest while sleeping face-up or even on your side, thus leading to a lack of rest.
Other symptoms that are known to present while experiencing a broken / fractured rib include:
- Dizziness, tired, or sleepy
- Fear and anxious
Who gets Broken Ribs?
There are a number of risk factors that can increase the risk of developing broken ribs – these risk factors include:
- Age – People who are older than 50 years old have a greater chance of breaking their ribs (such as due a fall) due to the general wear and tear of aging.
- Contact sports – Sports such as football, basketball, rugby, wrestling, or boxing all have a likelihood of experiencing a broken rib because of the repetitive chest and ribcage impact that are presented in the chosen sport.
- Occupational activities – Regular occupational activities, such as construction workers and carpenters, have an increased chance of broken ribs, especially if he or she falls or slips from a great height.
- Osteoporosis – Patients who are living with osteoporosis are at higher risk of fracturing their ribs due to the thinning and weakening of the bones.
How Does it Affect You? How Serious is it?
Some rib fractures can cause serious or life-threatening complications. Some of these complications include:
- Pneumonia – Pneumonia is a lung infection that can range from ‘mild’ to ‘severe’. It occurs when an infection causes the air sacs in your lungs to fill with fluid or pus. Therefore, if you don’t breathe deeply enough, mucous and moisture can build up in the lungs and lead to an infection such as pneumonia.
- Lung cancer – Lung cancer is the second most common cancer. One of the symptoms of lung cancer is rib cage pain or chest pain that worsens upon breathing deeply, coughing, or laughing. Having broken ribs can increase the chance of spreading lung cancer in your ribs.
- Collapsed lung – A collapsed lung occurs when air gets inside the chest cavity and creates pressure against the lung. Also known as pneumothorax, a collapsed lung is a rare condition that may cause chest pain and make it hard to breathe. One of the causes that can result in a collapsed lung is being punctured from a broken rib and air therefore escaping from the lung.
Other serious symptoms that may need further medical attention are:
- High fever.
- Coughing out blood or yellow-green mucus (phlegm).
- Severe pain that constantly worsen.
- Increasing shortness of breath.
Recommended Treatment & Rehabilitation
To diagnose a broken rib, a doctor will typically look for any signs of bleeding or bruising during a physical examination – he or she may also ask you about your pain level and if it is difficult to breathe. Afterwards, your doctor will order an X-ray for further rib details.
A hairline fracture will show as a crack or jagged edge on the bone if suspected. Your doctor will then be able to see any segments of floating bone on an X-ray. If your doctor suspects that the break has caused a serious lung injury, such as pneumothorax, he or she may recommend undergoing a computed tomography (CT) scan or ultrasound to rule out the condition.
Following a fractured rib injury, it is important to begin gently moving, as much as comfort allows, as soon as possible. Even a bruised rib can take up to 8-12 weeks to fully heal, therefore, it is important that you gradually build up your general exercise during this period. Following a physiotherapy session, you’ll be given guidance regarding specific exercises to aid your recovery.
Early mobilization is recommended to promote spinal mobility and prevent persistent rib pain. Physiotherapy breathing exercises may be combined with a spirometer, a device that measures the volume of air you breathe in and out. This will give you a better idea of how it should feel to take a full, deep breath. In addition, there is a technique called the active cycle of breathing to encourage deeper breaths and an effective cough, which is important to allow you to clear any sputum from your chest.
Following a fractured rib, the mid-spine region can become stiff due to pain and tightness in the chest region. Thoracic mobility with rotations and extensions can help avoid these issues and should be part of your exercise rehabilitation regime once the rib pain has subsided.
If you have pain or stiffness which does not fully settle with the range of movement and breathing exercises, your physiotherapist may use manual therapy techniques to help relieve pain and enable you to further progress with your rehabilitation. There are many different types of manual therapy and the type of treatment utilized that your physiotherapist will work with you. Manual therapy has been shown to have a neurophysiological effect, which reduces pain.
Once you have recovered from your rib pain, you can then perform select exercises at home to boost your recovery and return to your regular activities. Therefore, the following exercises include the following:
Sit upright in a chair and lift your arms, bending your elbows to 90 degrees. Alternatively, you can try to raise your arms and interlock your fingers. Next, gently squeeze your shoulder blades toward one another. Hold for 5-10 seconds and release. Return your arms to their original position, then repeat this stretch 5-10 times a day.
Bucket handle breathing
Sitting upright in a chair, place your hands on your sides. This is where your lower rib cage is located. Inhale slowly, breathing so your sides push into your hands. Hold for 10 seconds and exhale slowly before reacting this exercise 5-10 times a day.
Diaphragmatic breathing exercise
Sit upright in a chair and place one hand on your upper chest and the other on your abdomen. Then, inhale slowly and focus on pushing your stomach into your hand. Try to make sure your upper hand remains motionless. Tighten your stomach muscles as you exhale slowly, then repeat this exercise 5-10 times a day.
Sit upright in a chair and place your hands over your fractured rib area. You can also hold a pillow to your chest for support. Take a deep breath, and slowly and gently fill your lungs. Hold your breath for about 10 seconds, then exhale slowly. Finally, cough gently to help loosen mucus before repeating 5 times a day.
Alternative & Homeopathic Treatment
Most rib cage pain takes about 6 weeks to heal. In cases of a broken rib, however, it may (and is very likely) to take longer to recover. Some of these homeopathic treatments may help improve symptoms linked to broken ribs:
- Non-steroidal anti-inflammatory medications (NSAIDs) – such as acetaminophen or ibuprofen will support you in reducing further swelling and inflammation located in your affected rib. A pain-reliever cream may also be used to heal the affected area.
- Rest – Take a break from sports or occupation to allow yourself to heal without hurting yourself again.
- Ice application – Applying ice to the affected area may increase your recovery process by reducing swelling and inflammation. This is a great alternative if you choose to avoid taking oral anti-inflammatory medications.
- Avoid smoking – If you often smoke, reducing or stopping it will benefit the healing process after a broken rib.